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Community_Brain_Injury_Services_Referral_Form.pdf
Living
Situation: Alone With Family With Spouse Other Specify: ____________________...Name: ______________________________________...Emergency Contact: Name: __________________________...
https://www.southeasthealthline.ca/pdfs/Community_Brain_Injury_Services_Referral_Form.pdf
lgl_health_unit_smoking_resources_for_tobacco_for_general_public.pdf
assistance
,...prescription...primary care...provider, and...discretion of...the client’s...caseworker....Advise client to:...Contact their FHT...to determine whether...they are participating...If...
https://www.southeasthealthline.ca/pdfs/lgl_health_unit_smoking_resources_for_tobacco_for_general_public.pdf
HPE Local Quit Smoking
A free app that helps users stop smoking and start
living
...a healthy life....FAMILY DOCTORS AND PHARMACISTS...You can talk to your doctor or pharmacist about quit...smoking medications, such as...
https://www.southeasthealthline.ca/pdfs/hpe_public_health_local_quit_smoking_support_guide.pdf
September 20, 2009
At present, QELC provides
assistance
with the drafting and execution of simple wills, powers of attorney...for property, and powers of attorney for personal care,
assistance
with...
https://www.southeasthealthline.ca/pdfs/Queens%20Elder%20Law%20Clinic%20Client%20Application%20Form.pdf
Brenda, Dianne, Amanda, Kathy and Irene of Volunteer & Information Quinte wish to thank your organization for the loyalty and support you show to us
Volunteer & Information Quinte provides high quality, professional
assistance
to...the residents and agencies of Hastings & Prince Edward Counties by continuously...offering up-to-date information...
https://www.southeasthealthline.ca/pdfs/About-VIQ-Membership.pdf
Kingston_Access_Services_Application_Form.pdf
occasionally requires
assistance
it is the responsibility of the applicant or a person responsible for them to...book a support person for those trips requiring
assistance
....If the...
https://www.southeasthealthline.ca/pdfs/Kingston_Access_Services_Application_Form.pdf
500160-Complex-Adult-Seating-Clinic-Referral-2019-08-3.pdf
Please Note: If you require
assistance
for providing basic needs while attending clinic, a caregiver must accompany you....Date: YYYY/MM/DD Referring Physician (please print):...Time: HH:MM...
https://www.southeasthealthline.ca/pdfs/500160-Complex-Adult-Seating-Clinic-Referral-2019-08-3.pdf
“APPLICATION TO REGISTER” For Health Services
Do you require any
assistance
? ...(Please include: mobility aids, hearing aids, visual difficulties,...etc) _________________________________________________________________________...How did you...
https://www.southeasthealthline.ca/pdfs/BQWCHC_application_referral_form_oral_Health_Services.pdf
rac_lbp_patient_intake_form_march_2020.pdf
I have support from people who can
assist
me with activities in the home, work or community? ...(check one)... Strongly Agree Agree Neutral Disagree Strongly Disagree...PATIENT INTAKE...
https://www.southeasthealthline.ca/pdfs/rac_lbp_patient_intake_form_march_2020.pdf
CPC Patient Information Sheet
BussieDh...Ministry of Health ...Ontario Community Physiotherapy Clinic...Program: Patient Information...Questions? ...Please visit:...www.ontario.ca/physiotherapy...Ontario’s Community Physiotherapy...
https://www.southeasthealthline.ca/pdfs/Napanee%20Physiotherapy%20and%20Rehabilitation%20-%20OHIP%20Insured%20Physiotherapy%20Information.pdf
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